Long COVID

Most people who get sick with COVID-19 will recover within a week or even a few days. But for some, the symptoms of the disease can linger for weeks, months, or sometimes longer. This is known as long COVID. Long COVID can also refer to any medical condition that is linked to a COVID-19 infection that lasts for more than 3 months after your symptoms first appear.

Symptoms of long COVID

The symptoms of long COVID are similar to those of COVID-19 itself. They can also include additional symptoms. People with long COVID may have problems from different combinations of symptoms that may come and go over time.

The most common symptoms include:

• Tiredness or fatigue
• Fever
• Difficulty breathing or shortness of breath
• Cough
• Chest pain
• Fast or pounding heart beats
• Difficulty thinking or concentrating
• Headaches
• Problems sleeping
• Dizziness when you stand
• Change in smell or taste
• Depression or anxiety
• Diarrhea
• Stomach pain

Other symptoms can include joint or muscle pain, a rash, or changes in menstrual cycles. Some symptoms may get worse after physical or mental effort.

Some people with long COVID may also have symptoms that don’t show up on tests and are hard to explain. If you think you have long COVID, the Centers for Disease Control and Prevention recommends you review these tips before visiting your doctor.

What causes long COVID?

Doctors aren’t sure yet why some people get long COVID while others don’t. There are many potential factors, but no one cause has been determined. Some potential factors include:

• Blood clots that can prevent your lungs and other organs from working properly.
• Inflammation caused by an overreaction in your immune system.
• Autoimmune disorders. This happens when your immune system starts attacking other parts of your body.
• The continued presence of the COVID-19 virus in your body or other viruses that might be reactivated by it.

How is long COVID diagnosed?

Your doctor will diagnose long COVID by listening to your symptoms and your health history. If you have already been diagnosed with the COVID-19 virus, your doctor may order more tests to learn more about your symptoms and how to treat them.

This could include blood tests, chest x-rays or other imaging and lung function tests, which will tell your doctor how well your lungs are working.

Your doctor may also order other screenings including CT scans, which can measure how inflamed your lungs are; and electrocardiograms, which can help find issues with your heart.

Can long COVID be prevented or avoided?

While there is no 100% surefire way to prevent yourself from getting long COVID, you can take precautions that can dramatically lower your risk. Because you can’t get long COVID without getting COVID-19 first, the prevention steps for both are the same. They include:

• Regular handwashing with an antibacterial soap
• Avoiding others who may have been exposed to COVID-19
• Wearing a multilayer, snug-fitting mask in public places
• Getting the latest COVID-19 vaccination.

If you believe you have COVID-19, the first step is to get a test. You can test at home. If you cannot afford to purchase an at-home test at your local retail store, the U.S. Department of Health and Human Services will provide residential households in the U.S. with four, free at-home tests from the U.S. Postal Service (USPS).

In general, testing availability may differ depending on where you live. There are some no-cost testing centers. Check your local health department to see what locations near you are doing testing and if there is a fee to test. This may include hospitals and pharmacies that offer drive-thru testing during high COVID-19 infection periods in your local community. This will allow you to stay in your car to prevent the possible spread of COVID-19. Depending on the location, someone may approach your car to collect a sample, or they may ask you to collect it yourself. Samples for COVID-19 viral tests are collected through nasal swabs. Depending on where you get your test, you may get your results the same day or you may have to wait a few days. Find out more about COVID-19 testing.

Where you live or work can increase your chances of getting COVID-19 and long COVID, as can your access to health care. If you have underlying health conditions or have not been vaccinated, you should seek treatment as soon as symptoms appear.

There is some evidence that taking antiviral medications within five days of a positive COVID test can reduce your risk of long COVID. Talk to your doctor if you have a positive test result.

Long COVID treatment

Because it can include so many different symptoms, there is not just one treatment for long COVID. Your doctor may try a variety of approaches to find one that works best for you.

The most common treatments include:

• Medication. This will treat most of the major symptoms including coughs, headaches, nausea, and diarrhea. If your doctor finds an underlying cause for your long COVID symptoms, they may be able to prescribe medications specific to that cause.
• Stellate ganglion or olfactory retraining. Don’t let the big words scare you. This is just a fancy way of saying treatments that can help bring back your sense of smell and taste. A stellate ganglion block numbs nerves in your neck that can affect your sense of smell. Olfactory retraining uses smells to help your brain remember what things should smell like.
• Physical therapy. This can help you deal with pain or movement issues you might be experiencing. It can include exercise, massage, and other treatments.
• Pulmonary rehabilitation. This is a special kind of exercise program that can help you breathe better and learn how to manage your breathing issues at home.
• Counseling. This can help you deal with any mental issues you might be having connected with long COVID, such as depression or anxiety.

Living with long COVID

As the name implies, long COVID can mean that symptoms will occur for weeks, months and in some cases more than a year. You should see your doctor if you have symptoms that recur after your first COVID symptoms have gone away or if they disrupt your daily life.

While doctors are learning more every day about long COVID, there is still much that is unknown. Long COVID symptoms can also vary from person to person. It may take some trial and error to properly treat your symptoms.

If you had COVID-19 and were hospitalized or needed intensive care, your risk for having long COVID increases. There is also new evidence that repeated COVID-19 infections could increase the likelihood of developing long COVID. That is why it is important to get the vaccine. Even if you do get COVID-19, the vaccine will reduce your chances of getting severely ill.

Questions to ask your doctor

• How do I know if I have long COVID?
• What are my treatment options?
• What is causing my symptoms?
• How long will my symptoms last?

Resources

Centers for Disease Control and Prevention: Long COVID or Post-COVID Conditions

The Cleveland Clinic: Long COVID

Familydoctor.org: COVID-19